Cefepime Is a Fourth-Generation Cephalosporin Antibiotic Given by IV to Treat Serious Bacterial Infections

If your doctor has mentioned Cefepime — or you've seen it on your hospital medication list — you probably have questions. What is it? Why is it given by IV instead of as a pill? And what should you know before starting treatment?

This guide covers everything patients need to know about Cefepime in plain language: what it is, what it treats, how it's dosed, who should avoid it, and what it costs in 2026.

What Is Cefepime?

Cefepime is the generic name for an antibiotic that was originally sold under the brand name Maxipime. It belongs to a class of antibiotics called fourth-generation cephalosporins, which are part of the broader beta-lactam antibiotic family (the same family that includes penicillins).

Here are the key facts:

• Generic name: Cefepime Hydrochloride
• Brand name: Maxipime
• Drug class: Fourth-generation cephalosporin (beta-lactam antibiotic)
• Manufacturer: Originally marketed by Bristol-Myers Squibb; now available as generic from multiple manufacturers including B. Braun, Apotex, Baxter, and Hospira (Pfizer)
• Administration: IV (intravenous) infusion or intramuscular (IM) injection only — not available as a pill
• Controlled substance: No — Cefepime is not a controlled substance

Cefepime works by destroying the cell walls of bacteria, which kills them. It's especially effective against a wide range of both Gram-positive and Gram-negative bacteria, including some that are resistant to older antibiotics. For a deeper explanation of how Cefepime works, see our article on Cefepime's mechanism of action.

What Is Cefepime Used For?

Cefepime is FDA-approved to treat several types of moderate to severe bacterial infections:

• Pneumonia — including hospital-acquired (nosocomial) pneumonia, which tends to be caused by more resistant bacteria
• Febrile neutropenia — a dangerous condition where cancer patients undergoing chemotherapy develop fever with very low white blood cell counts. Cefepime is a first-line treatment for this emergency.
• Urinary tract infections (UTIs) — both uncomplicated and complicated UTIs, including pyelonephritis (kidney infection)
• Skin and soft tissue infections — uncomplicated skin infections caused by susceptible bacteria
• Intra-abdominal infections — when used in combination with Metronidazole
• Bacterial meningitis — in pediatric patients (children)

Doctors also use Cefepime off-label for conditions such as sepsis and bacteremia, brain abscess, osteomyelitis (bone infection), endocarditis, and pulmonary exacerbations in cystic fibrosis patients.

How Is Cefepime Taken?

Cefepime is not an oral medication. It's given in one of two ways:

• Intravenous (IV) infusion — The most common method. The medication is mixed with fluid and infused through a vein, typically over 30 minutes. For Pseudomonas infections, extended infusions over 3 hours may be used.
• Intramuscular (IM) injection — Given as a shot into a large muscle. This is less common and typically reserved for milder infections.

Cefepime is available in several formulations:

• Powder for injection: 500 mg, 1 g, and 2 g vials
• Premixed frozen IV solutions: 1 g/50 mL and 2 g/100 mL

Typical Dosing

Dosing depends on the type and severity of your infection, as well as your kidney function:

• Most infections: 500 mg to 2 g IV or IM every 8-12 hours
• Febrile neutropenia: 2 g IV every 8 hours
• Pseudomonas infections: 2 g IV every 8 hours (often as an extended 3-hour infusion)
• Pediatric patients: 50 mg/kg every 8-12 hours (maximum 2 g per dose)

Treatment typically lasts 7 to 14 days, depending on the infection. Dose adjustments are required for patients with kidney impairment (creatinine clearance of 60 mL/min or less). This is critically important because improper dosing in patients with kidney problems can lead to serious neurotoxicity.

Where You Receive It

Most patients receive Cefepime in one of three settings:

1. Hospital — The most common setting, especially for serious infections
2. Outpatient infusion center — For patients who are stable enough to go home between doses
3. Home infusion therapy — Some patients complete their antibiotic course at home with a portable IV pump, coordinated by a home infusion pharmacy

Who Should Not Take Cefepime?

Cefepime is not safe for everyone. You should not receive Cefepime if you have:

• A known allergy to Cefepime or any cephalosporin antibiotic
• A history of immediate hypersensitivity reaction to penicillins or other beta-lactams — While cross-reactivity is only about 1-2%, your doctor needs to weigh the risk
• A known allergy to L-arginine — The Cefepime formulation contains L-arginine

Special caution is needed for:

• Elderly patients — Higher risk of neurotoxicity; dose adjustment based on kidney function is essential
• Patients with kidney disease — Dose must be reduced; failure to adjust can cause seizures and encephalopathy
• Pregnant women — Category B; use only if clearly needed
• Breastfeeding women — Cefepime is excreted in breast milk in low concentrations; considered low risk

For a detailed look at side effects and risks, read our guide on Cefepime side effects. And to learn about medications that interact with Cefepime, see our article on Cefepime drug interactions.

How Much Does Cefepime Cost?

Since Cefepime is available as a generic, costs are lower than they would be for a brand-name IV antibiotic — but they can still add up, especially for a full treatment course:

• Per vial (generic): Approximately $10 to $40 for a 1 g or 2 g vial
• Full treatment course: $200 to $500+ depending on dose, duration, and where you receive it
• With discount cards: SingleCare can bring a 9-vial supply of 2 g vials down to about $93 (versus $363 retail)

If you receive Cefepime in a hospital, it typically falls under your inpatient pharmacy benefits. For outpatient or home infusion, your insurance may cover it under medical benefits (Medicare Part B) or prescription drug benefits (Part D), but prior authorization may be required.

For more ways to reduce your out-of-pocket costs, read our guide to saving money on Cefepime.

Final Thoughts

Cefepime is a critical antibiotic for fighting serious bacterial infections. It's given by IV, typically in a hospital or through home infusion therapy, and is most commonly prescribed by infectious disease specialists, hospitalists, and oncologists. If you need help finding a prescriber, check our guide on how to find a doctor who prescribes Cefepime.

If you're having trouble finding Cefepime due to the ongoing shortage, visit Medfinder to check real-time availability at pharmacies near you. For background on why supply has been limited, read our article on why Cefepime is so hard to find.